How to Treat Dissociative Identity Disorder

Dissociative identity disorder (DID) is a mental health condition that causes a person to have more than one personality state. This condition, formerly called multiple personality disorder or split personality disorder, can cause discontinuity (a distinct break) in a person's memory, perceptions, thoughts, and behaviors.

These symptoms cause significant distress and can interfere with daily life. Treatment varies from person to person and may include one or more therapies.

This article discusses psychotherapy techniques, medications, and coping strategies used to treat DID.

Psychotherapy for DID

Psychotherapy, or talk therapy, is the most effective treatment for dissociative identity disorder. This condition frequently develops from childhood abuse or other traumatic events. Dissociative episodes, or "shifts" from one personality to another, can be triggered by stress or other factors in the environment (sounds, sights, smells) that remind the person of their trauma.

For this reason, the goals for psychotherapy may include processing painful memories, managing sudden changes in behavior, learning new coping skills, and bringing the multiple identities back into one functional person.

This form of treatment may use several different types of therapeutic approaches, including cognitive behavioral therapy, dialectical behavioral therapy, psychodynamic psychotherapy, eye movement desensitization and reprocessing (EMDR) therapy, and schema therapy.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is based on the belief that dysfunctional thoughts lead to dysfunctional behaviors or emotions. For example, a person with DID who has suffered from abuse might always expect negative outcomes in their relationships. CBT challenges these negative thought patterns and replaces them with thoughts based in current reality.

CBT also helps the individual process past traumas and learn how to cope with the depression that often occurs with DID.

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) is a type of therapy that focuses on both change and acceptance. DBT focuses on these four main skills:

• Distress tolerance: Learning to manage overwhelming feelings
• Mindfulness: Being aware of your surroundings and what is happening in the present moment
• Interpersonal effectiveness: The ability to effectively communicate and assert your needs and boundaries in relationships
• Emotion regulation: Understanding your emotions and learning how to ride out strong feelings without acting on them

Psychodynamic Psychotherapy

Psychodynamic psychotherapy focuses on helping people better understand unconscious aspects of their suffering. This type of therapy uses a variety of techniques to help a person understand how the past plays a role in their current behaviors.

Eye Movement Desensitization and Reprocessing (EMDR)

The purpose of EMDR therapy is to reduce distress associated with traumatic memories. During EMDR, a person thinks about past trauma while also performing a physical task to stimulate both sides of the brain—most commonly eye movements. This therapy sometimes includes tapping, listening to sounds, or walking/pacing.

Schema Therapy

A schema is a mental framework that a person develops to help interpret their experiences. Oftentimes, people with dissociative identity disorder have experienced childhood trauma and/or abuse that led to negative schemas and a lack of positive coping skills.

Schema therapy integrates aspects of several different types of psychotherapy (talk therapy). Goals of schema therapy include:

• Helping a person identify their schemas and healing negative schemas
• Increasing awareness of childhood memories and the emotions, body sensations, and beliefs that go along with them
• Helping a person gain control over how they respond to triggers in their environment
• Finding healthy ways to get core emotional needs met
• Removing power from past traumatic memories

Medications for DID

There's no specific medication for treatment of dissociative identity disorder. However, medications can be effective for treating depression and anxiety that often occur with this condition.

Antidepressants

Antidepressants help manage symptoms of depression by changing levels of chemicals called neurotransmitters in the brain. There are several types of antidepressants, including:

• Selective serotonin reuptake inhibitors (SSRIs): Such as Lexapro (escitalopram) and Prozac (fluoxetine)
  
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): Such as Cymbalta (duloxetine) and Effexor (venlafaxine)
• Tricyclic and tetracyclic antidepressants: Such as Asendin (amoxapine) and Elavil (amitriptyline)
• Monoamine oxidase inhibitors (MAOIs): Such as Marplan (isocarboxzaid) and Nardil (phenelzine)
• Atypical antidepressants: Such as Desyrel (trazodone) and Wellbutrin (bupropion)

Antianxiety Medications

One group of medications commonly used to treat anxiety are benzodiazepines such as Klonopin (clonazepam), Xanax (alprazolam), Valium (diazepam), and Ativan (lorazepam). These medications have short-lasting effects and can be taken while a person is experiencing anxiety symptoms to decrease muscle tension and promote relaxation.

SSRIs are also used to treat anxiety disorders.

Antipsychotic Medications

Antipsychotic medications are typically used to treat "psychosis," a condition in which a person has lost touch with reality. However, these medications can also be used to treat severe depression, bipolar disorder, and may treat symptoms associated with dissociative identity disorder. Examples include Abilify (aripiprazole) and Risperdal (risperidone).

Coping Strategies for DID

A variety of coping strategies can be helpful for managing life with dissociative identity disorder. These include:

• Utilizing mindfulness: Bringing thoughts and attention to the present moment can help a person with DID become more accepting of uncontrollable events.
• Exercising: Being physically active can reduce symptoms of anxiety and depression that often occur with DID.
• Maintaining a healthy diet: Removing processed foods and added sugars from your diet can decrease inflammation in your body, which may contribute to anxiety and depression symptoms.
• Getting enough sleep: Getting enough sleep can decrease symptoms of DID.
• Identifying triggers: With the help of a therapist, a person's triggers for dissociative episodes can be identified, and possibly avoided.

Summary

Dissociative identity disorder is a mental health condition that is commonly treated with psychotherapy, including cognitive behavioral therapy, dialectical behavioral therapy, psychodynamic psychotherapy, eye movement desensitization and reprocessing (EMDR) therapy, and schema therapy. In some cases, medications might be used to treat anxiety and/or depression that often occur with DID. Positive coping strategies can also improve daily life.

A Word From Verywell

Dissociative identity disorder can affect every area of your life. In some cases, it can prevent a person from working or having meaningful relationships. However, seeking treatment through therapy and other support networks can decrease dissociative episodes, or possibly eliminate them altogether. You're not alone. There are resources out there that can help you live a full life with DID.